Basic Information
| Provider Information | |||||||||
| NPI: | 1609376359 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LETCHER | ||||||||
| FirstName: | JESSICA | ||||||||
| MiddleName: | SIERRA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4A SKIDAWAY VILLAGE WALK | ||||||||
| Address2: | |||||||||
| City: | SAVANNAH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 314415213 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9125982793 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4A SKIDAWAY VILLAGE WALK | ||||||||
| Address2: | |||||||||
| City: | SAVANNAH | ||||||||
| State: | GA | ||||||||
| PostalCode: | 31441 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9125982793 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/20/2018 | ||||||||
| LastUpdateDate: | 09/20/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | RN203541 | GA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LF0000X | RN203541 | GA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.